Exposure to solar ultraviolet radiation (UVR) in British Columbia’s outdoor workers Cheryl E. Peters 1,2 Sunil Kalia 3 Paul A. Demers 4,5 Anne-Marie Nicol 2 Mieke W. Koehoorn 1 1.School of Population and Public Health, University of British Columbia 2.CAREX Canada, Faculty of Health Sciences, Simon Fraser University 3.Dermatology and Skin Science, University of British Columbia 4.Occupational Cancer Research Centre, Cancer Care Ontario 5.Dalla Lana School of Public Health, University of Toronto

Background Skin cancer = ~88,000 of ~269,000 new cancer cases (2013) 1

Health impacts from UV radiation Ozone Cloud cover Latitude Season Air pollution Elevation Reflection Ozone Cloud cover Latitude Season Air pollution Elevation Reflection Outdoor work Pattern of exposure  Intermittent  Cumulative Behaviour:  Sun-seeking  Sun-protective Genetics:  Skin colour  Sun sensitivity Cultural  Dress  Other behaviours Immune competence Outdoor work Pattern of exposure  Intermittent  Cumulative Behaviour:  Sun-seeking  Sun-protective Genetics:  Skin colour  Sun sensitivity Cultural  Dress  Other behaviours Immune competence Melanoma Squamous cell carcinoma (skin) Basal cell carcinoma (skin) Solar keratoses Sunburn Cortical cataract Pterygium Cold sores Sqamous cell carcinoma (cornea and conjunctiva) Melanoma Squamous cell carcinoma (skin) Basal cell carcinoma (skin) Solar keratoses Sunburn Cortical cataract Pterygium Cold sores Sqamous cell carcinoma (cornea and conjunctiva) UV radiation Modified from ‘Global burden of disease from solar UVR’, World Health Organization, 2006

Number of outdoor workers in Canada 1.5 million exposed 8.8% of the working population Most of those exposed are men (82%) Peters CE, Nicol AM, Demers PA. Prevalence of exposure to solar ultraviolet radiation (UVR) on the job in Canada. Can J Public Health (3):

The Outdoor Workers Project: Solar exposure in BC construction workers Objectives: 1.To characterize ultraviolet radiation exposure in BC’s outdoor construction workers 2.To understand the determinants of solar UVR exposure 4

Outdoor Workers Project: Methods 2.Questionnaire 3.Activity diary 1.UV dosimeter 5

Results (1): Recruitment and demographics CharacteristicOutdoor workers Total number78 Sex (n males, %)73 (95%) Age (mean, range)38 ( ) Race (n Caucasian, %)73 (95%) Yes to childhood sunburn (n, %)45 (58%) Blonde or red hair (n, %)9 (12%) Light coloured eyes (n, %)49 (64%) Skin types I or II (n, %)11 (14%) 6

Results (2): Exposure levels by job type 7

Results (3): Exposure levels Measure Outdoor workersControls Number of measured days34646 Standard Erythemal Dose results Mean SED (burning threshold for un-tanned skin is SED) SD Minimum< Maximum UV Index results Mean UV Index (full day) SD Minimum00 Maximum Mean UV Index (outdoor observations only)

Results (4): Sunburn in outdoor workers by time spent outside at work 9

Discussion: Outdoor Workers Project Potential for  solar UV radiation at work in the summer; levels differ by job site and are highly variable Workers are regularly getting sunburned at work 10

Conclusions 1.5 million Canadians likely exposed to solar UVR on the job, evidence suggests inadequate protection Exposure levels in Vancouver summers are at high levels, sometimes dangerously so We have many challenges to address 11

Acknowledgements – PhD committee: Mieke Koehoorn Sunil Kalia Paul Demers Anne-Marie Nicol – Brynn Bourke & The BC Building Trades – Van Pile Ltd. – Seaspan / Vancouver Shipyard – JDG Construction – Environment Canada (Atmospheric Monitoring) – WinVan Paving Ltd. – Arbutus Ridge Golf & Country Club – Outdoor Workers Project participants

Farming 264,000 exposed Residential Building Construction 108,000 exposed Services to Buildings 83,000 exposed Foundation & Building Exterior Contractors 68,000 exposed Amusement & Recreation 45,000 exposed

Examples of exposure patterns